Top tips for breast cancer prevention, by Dr. Anne McTiernan, a cancer prevention researcher in the Public Health Sciences Division at Fred Hutchinson Cancer Research Center. At Fred Hutch, our interdisciplinary teams of world-renowned scientists and humanitarians work together to prevent, diagnose and treat cancer, HIV/AIDS and other diseases. Our researchers, including three Nobel laureates, bring a relentless pursuit of, and passion for, health knowledge and hope to their work and the world.
Together, our researchers are discovering new ways to detect cancers earlier, when cure rates are highest; developing effective treatments with fewer side effects; and learning how to prevent cancers from growing in the first place
1. Avoid becoming overweight. Obesity raises the risk of breast cancer after menopause, the time of life when breast cancer most often occurs. Avoid gaining weight over time, and try to maintain a body-mass index under 25 (calculators can be found online).
2. Eat healthy to avoid tipping the scale. Embrace a diet high in vegetables and fruit and low in sugared drinks, refined carbohydrates and fatty foods. Eat lean protein such as fish or chicken breast and eat red meat in moderation, if at all. Eat whole grains. Choose vegetable oils over animal fats.
3. Keep physically active. Research suggests that increased physical activity, even when begun later in life, reduces overall breast-cancer risk by about 10 percent to 30 percent. All it takes is moderate exercise like a 30-minute walk five days a week to get this protective effect.
4. Drink little or no alcohol. Alcohol use is associated with an increased risk of breast cancer. Women should limit intake to no more than one drink per day, regardless of the type of alcohol.
5. Don’t smoke. Research suggests that long-term smoking is associated with increased risk of breast cancer in some women.
6. If you bear children, breast-feed your babies for as long as possible. Women who breast-feed their babies for at least a year in total have a reduced risk of developing breast cancer later.
7. Avoid hormone replacement therapy. Menopausal hormone therapy increases risk for breast cancer. If you must take hormones to manage menopausal symptoms, avoid those that contain progesterone and limit their use to less than three years. “Bio-identical hormones” and hormonal creams and gels are no safer than prescription hormones and should also be avoided.
8. Get regular breast cancer screenings. Follow your doctor or health care provider’s recommendations to decide what type of screening you need and how often you need it.
If you are at high risk for breast cancer, such as having a particular gene like a BRCA gene, or have a strong family history or have had high-risk benign breast disease in the past, talk with your doctor about other options for you which might include:
A. Extra screenings. For some women, MRI or ultrasound screenings can add valuable information to regular mammogram screening.
B. Estrogen-blocking drugs. Women with a family history of breast cancer or who are over age 60 should talk to their doctor about the pros and cons of estrogen-blocking drugs such as tamoxifen, raloxifine, and aromatase inhibitors.
C. Prophylactic surgery to remove breasts and/or ovaries. Women who have had both breasts surgically removed reduce their risk of breast cancer by over 90 percent. Women who have had both ovaries removed have about half the risk of developing breast cancer as women with intact ovaries. Clearly these options are most appropriate for women at very high risk.